Help For Abdominal Hernias

If you’ve ever suffered an abdominal hernia, it means that there’s been a breakdown of the abdominal wall allowing something internal to protrude through it.

There are two classifications of hernias: direct and indirect. Indirect hernias are something a person is born with. Direct hernias are acquired, and occur when the build-up of intra-abdominal pressure is too high relative to the strength of the abdominal wall. Due to a deficit in the abdominal wall, when pressure gets too high or through prolonged muscle exhaustion, the wall tears apart and the intestine bulges out of the opening.

Common causes are sports, obesity, heavy lifting, coughing and pregnancy. Hernias are common in athletes because of the demand athletes put on their bodies. If an athlete is asked to lift something that causes intra-abdominal pressure the abdominal wall can’t hold, a hernia can occur.

There are three main reasons athletes may develop a hernia. One, either the athlete or the coach overestimates what the athlete can do. Two, the athlete is coming back after a prolonged rest and still believes their strength is what it was before their break. Third, the hernia develops over time due to prolonged muscle exhaustion. Over time, the abdominal wall has become exhausted and one lift, tackle or jump creates too much intra-abdominal pressure for the athlete’s already taxed abdominal wall to handle.

With a hernia, you generally experience lower abdominal pain, have a bulge in your lower abdominal area and feel pain when you exert force or sneeze. Force causes extra intra-abdominal pressure, straining the already taxed abdominal wall.

If you’ve been diagnosed with a hernia, follow any guidelines your doctor recommends. While waiting for surgery, do not continue to lift heavy weights or play extreme sports. Recovery time post-surgery depends on the type of hernia, your fitness level before the injury, and the type of surgery you have (i.e., laproscopic or open surgery). Your doctor will advise you on the post-surgery recovery time appropriate for your individual surgery.

While Waiting For Your Surgery

Avoid heavy lifting. Lifting heavy objects will increase intra-abdominal pressure, which has the potential to exacerbate the injury. If you do have to lift things in your daily life, don’t hold your breath while lifting.

Stay away from isometric exercises such as planks and wall squats. They build up intra-abdominal pressure. Stay away from sports like skiing that require holding a static position.

Work on getting down to a healthy weight. Excess weight, especially in the form of a “beer” belly, can exacerbate the problem. After the surgery, try to maintain your weight loss. Excess weight will increase the likelihood of the hernia of occurring again.

After Surgery

If you acquired a hernia it means your abdominals were probably weak. Alternatively, as in the case of an athlete, your abdominals were strong but not relative to the demands that were being placed on them.

Once you’ve been cleared to exercise, one of your goals should be to strengthen your core. Don’t just do a million crunches to train the superficial rectus abdominals (i.e., “six-pack abs”). Work on the deeper core muscles that stabilize the spine. Crunches (or any type of flexion exercise that involves curling your head towards your chest) primarily work the rectus abdominals.

After a hernia operation, make sure you work the transverse abdominals, internal oblique, external oblique multifitus and pelvic floor. These muscles help support the spine and help coordinate muscle contractions that allow you to do functional exercises such as picking something up or pushing open a door.

Muscles that have been cut through during surgery will become dysfunctional. Therefore, training the muscles of the core is important since hernia surgery will inhibit the brain’s neurological connection to these core muscles.

Due to the surgery and resulting scarring your brain will have trouble communicating with your muscles, so it’s important to spend time retraining those neurological connections. Treat your abdominal scars by massaging them with massage oil. This helps re-train the nervous system to recognize the existence of muscles that the scar runs through.

Sample Exercise: Foam Roller "March"

Lie on your back on the roll with the roller positioned lengthwise along your spine. Have your arms resting by your side on the floor. Lift your opposite arm and leg off the floor without letting anything in your spine or pelvis move. Alternate sides for 20 reps. To increase the intensity, lift one leg up to 90 degrees and hold it there as you alternate lifting one arm off the ground at a time. Repeat 20 times, then switch sides.

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About the Author - Kathleen Trotter

Kathleen Trotter is a personal trainer and Pilates equipment specialist located in downtown Toronto. She is currently completing her masters at the University of Toronto in Exercise Science. She has written articles for various magazines and on line publications such as chatelaine, Glow magazine, Canadian Running, Best Health magazine online, AOL on line, Pilates COREterly. She has also been featured on MTV and global as a fitness expert. Take a look at her website kathleentrotter.com for a full list of credentials and certifications. Kathleen also is a regular contributor to the Globe and Mail newspaper in Toronto.